This grant will be used to further develop a portable device called a medication monitor, assemble enough units for a reasonable study, and evaluate its usefulness in monitoring and improving patient adherence with self administered medication. Using a microprocessor with time keeping ability and a gate mechanism, the device will determine when patients take individual pills from a container and prevent them from taking unprescribed medication. The device includes an audible means to remind and instruct the patients what to take. The evaluations are designed to determine if the device 1) will provide adequate surveillance of TB patients given self administered medication, 2) can facilitate programs of outpatient detoxification for patients dependent on controlled substances, and 3) is useful in studying the adherence problem in a wide variety of illnesses. The device will improve data derived from outpatient drug trials and lead to the reduction of health care costs for those patients whose poor medication adherence leads to repeated expensive emergency room visits and hospitalizations by detecting poor adherence which is promptly followed by appropriate interventions to correct the problem. The capability to prevent unprescribed medication use can be used to improve both the inpatient and outpatient use of narcotics. PROPOSED COMMERCIAL APPLICATION: The equipment we propose to produce will create extensive commercial opportunities by solving serious problems in the treatment of many illnesses including TB, AIDS, epilepsy, pain control, chemical dependency, psychiatric disease, hypertension, and conditions requiring anti coagulation. In addition it will reduce health care costs.